DOCTORS | OrthoRAPID

top of page

Patients

Allied Health

Doctors / NP

(02) 6952 1620 7am - 9pm EVERY DAY
CLICK BELOW

Doctors Access

OrthoRAPID accepts referrals from GPs & emergency departments DIRECTLY

Just like clinical handover, communication is key

If you require your patient to be seen urgently, phone conversation is PREFERRED

A plain x-ray is REQUIRED as part of your referral

Medical Referral Form

Doctors & Nurse Practitioners can refer by:

email - admin@momentumorthopaedics.com

Fax - (02) 6041 3377

Medical Objects - Provider Number 223653XL

Or by completing the form below. It can be used for both the OrthoRAPID urgent service and our elective orthopaedic services.

A completed PDF copy will be automatically sent to our office and to your nominated email address if provided.

Patient Details

Patient's Full Name

Patient's Phone Number

Patient's Medicare Number

Patient's Date of Birth * required

Patient's Email Address

Reference Number

Patient's Insurance Status *

Private Health Fund

Workcover

TAC

Veteran's Affairs

Private Self-Funded

Uninsured

Unknown

Clinical Details

Relevant Clinical Information

Has your patient had investigations / imaging perfromed?

None

X-Ray

Ultrasound

CT Scan

MRI

Other

Where were these investigations performed

Referrer Details

Referring Doctor / Nurse Practitioner

Doctor's / Nurse Practitioner's Email Address

Practice Address *

GRIFFITH BASE HOSPITAL, 1 Noorebar Ave, Griffith NSW 2680 | Ph: 02 6969 5555

WAGGA WAGGA BASE HOSPITAL, Edward St, Wagga Wagga NSW 2650 | Ph: 02 5943 1000

OTHER

Practice Name

Practice Phone Number

Practice Address

Provider Number

Referral Date * required

Signature

Thanks for submitting!

Expert Injury Care for Griffith & Surrounding Areas

OrthoRAPID is the injury management / trauma division of Momentum Orthopaedics Pty Ltd

ABN 67 146 694 760

We specialise in hip & knee replacements too! Contact our elective orthopaedics division

www.momentumorthopaedics.com

bottom of page